““Pain equals damage” is easily one of the biggest pain myths of all. No, pain does NOT equal damage.“
Scenario 3 is not uncommon at all, in fact most people have experienced tissue damage without pain. No? How about that mysterious bruise or that cut you had no idea how you got? The bruise and the cut are definitive signs of tissue damage, yet you had no pain!
I once had a mysterious bruise on my arm that was so big my patients became concerned about my safety! It was quite an impressive bruise once I realised it existed. It was about 5cm in diameter situated perfectly on the “grabbing” spot on my arm. I had no idea how I got it! I even went around my house and at work trying to match it up with something I could have bumped into and found nothing. It remains one of the biggest mysteries of my life to this day.
Scenario 4 is the least well known yet it is something experienced by 1 in 5 Australian! Pain in the absence of tissue damage is what chronic pain is all about. How is this possible? It is possible because pain is not a representation of the state of your tissue. Rather, pain is a complex biopsychosocial phenomenon with a myriad of contributing factors. The state of your tissue can be one such factors, however, it can not be a factor at all.
“Pain in the absence of tissue damage is what chronic pain is all about. Chronic pain is experienced by 1 in 5 Australian.“
You would have experienced something similar too, such as touching something hot or stepping on something sharp, there was aggressive pain and the pain made you stop. If you haven’t stopped, you probably would have hurt yourself. That’s how pain is supposed to work, as a warning system.
Pain serves a very important function of protecting us from danger, we need it for our survival. However, sometimes pain persists when there is no threat and this is a nervous system sensitivity issue and not a tissue damage issue. In people with chronic pain, the warning system is sensitised, the threshold for danger is lowered, and the alarm goes off when there is no need to. Imagine being stuck with an overprotective body guard who is easily spooked and can only respond to threats the way that’s usually reserved for the ultimate zombie apocalypse? It will be horrible and highly disruptive to your life to say the very least.
“Sometimes pain persists when there is no threat and this is a nervous system sensitivity issue and not a tissue damage issue.“
“It is possible to retrain your nervous system, to once again read threats correctly and respond appropriately.“
Selina is a singer-composer-physiotherapist based in Brisbane, Australia. She is the director of MoveMedics and its sister brands: Voice Physio & Pole Physio. She is passionate about dispelling misinformation, simplifying healthcare, and empowering people with evidence-based knowledge for healthy and pain-free living. She enjoys running, attempting handstands, and publishes music under her nom de plume, Asirus.